Jump to: Page Content, Site Navigation, Site Search,

Older people

Evidence

This section contains a brief overview of the research carried out in this area. The evidence is divided into the settings listed here.

View overview

With improved living conditions and better health care throughout life, life expectancy continues to increase in developed and most developing countries. This combined with declining birth-rates, particularly in developed countries, has created an unprecedented shift in the age structures of most populations, with a dramatic increase in the proportion of the population aged over 65. Ill-health and the need for health and care services is increasingly concentrated in this segment of the population, particularly in those aged 80 plus.

Goals of health policy are to extend healthy active life, and to reduce the need for unnecessary hospital care or long-term residential care. Older people want to retain their independence, not having to rely on support from others.

Interventions to decrease the length of acute hospital stay among older people

View Methodology

Topics searched

We searched for interventions in older people with complex needs (for example, chronic obstructive pulmonary disease, heart failure, hip fracture, and elective hip or knee replacements) with any comorbidities.

We excluded studies that had drug treatment as the sole intervention or unvalidated self reported outcomes alone.

Dates and study types searched

We searched for systematic reviews published from 1990 until September 2006 and randomised controlled trials published from 2001 until September 2006.

Databases searched

We searched Medline, Embase, and the Cochrane Library for relevant studies. We also searched DARE, NHS EED, Trip database, Health evidence.ca, and the WHO Health Evidence Network (HEN).

Search strategies

These are searches that have been conducted on Ovid Medline (http://gateway.ovid.com/). The other searches have been adapted from this one to accommodate the search engine of each specific database.

  1. exp Aged/
  2. (older adj2 (adult$ or person$ or people$ or man or men or wom$n)).ti,ab.
  3. elderly.ti,ab.
  4. (senior citizen$ or seniors).ti,ab.
  5. "Length of Stay"/
  6. patient discharge/
  7. (early adj3 (discharg$ or dismiss$ or dehospitali$ or deinstitutionali$)).ti,ab.
  8. ((decreas$ or reduc$ or shorten$) adj3 (LOS or length of stay or (duration adj2 stay) or (hospital adj2 stay))).ti,ab.
  9. (COPD or chronic obstructive pulmonary disease or heart failure or hip fracture$ or orthop$edic$ or arthroplasty or hip replac$ or knee replac$).ti,ab.
  10. Geriatrics/
  11. or/1-4
  12. or/5-8
  13. or/9-10
  14. 11 and 12 and 13

Interventions to decrease hospital admissions among older people

View Methodology

Topics searched

We searched for interventions in older people with complex needs, regardless of any comorbidities.

We excluded studies that had drug therapy as the sole intervention.

We also excluded studies in which “admission” or “readmission” was a secondary outcome, and therefore, not the real focus of the study.

We excluded studies that had unvalidated self reported outcomes alone.

Dates and study types searched

We searched for systematic reviews published from 1990 until September 2006 and randomised controlled trials published from 2001 until September 2006.

Databases searched

We searched Medline, Embase, and the Cochrane Library for relevant studies. We also searched DARE, NHS EED, Trip database, Health evidence.ca, and the WHO Health Evidence Network (HEN).

Search strategies

These are searches that have been conducted on Ovid Medline ( External Link ). The other searches have been adapted from this one to accommodate the search engine of each specific database.

  1. exp Aged/
  2. (older adj2 (adult$ or person$ or people$ or man or men or wom$n)).ti,ab.
  3. elderly.ti,ab.
  4. (senior citizen$ or seniors).ti,ab.
  5. (decreas$ adj3 (admission$ or admittance$ or institutionali$ or hospitali$)).ti,ab.
  6. (prevent$ adj3 (admission$ or admittance$ or institutionali$ or hospitali$)).ti,ab.
  7. (reduc$ adj3 (admission$ or admittance$ or institutionali$ or hospitali$)).ti,ab.
  8. (avoid$ adj3 (admission$ or admittance$ or institutionali$ or hospitali$)).ti,ab.
  9. patient admission/
  10. deinstitutionalization/
  11. or/1-4
  12. or/5-10
  13. 11 and 12

Interventions to increase levels of exercise, or physical activity, or both in community dwelling older people (age 65 and older)

View Methodology

Topics searched

We searched for interventions to increase exercise or physical activity in older people, regardless of any comorbidities. Because of the heterogenicity of the studies found, we focused on studies that looked at “uptake” of physical activity in participants. These studies mentioned outcomes such as minutes of exercise, adherence to exercise, aerobic capacity, strength, calories expended, Vo2 max, or other outcomes indicative of exercise. They may have mentioned quality of life or health status or social functioning.

We excluded studies that had drug treatment as the sole intervention.

We excluded studies that had unvalidated self reported outcomes alone, or if “disease progression” was the only outcome reported.

Dates and study types searched

We searched for systematic reviews published from 1990 until September 2006 and randomised controlled trials published from 2001 until September 2006.

Databases searched

We searched Medline, Embase, and the Cochrane Library for relevant studies. We also searched DARE, NHS EED, Trip database, Health evidence.ca, and the WHO Health Evidence Network (HEN).

Search strategies

These are searches that have been conducted on Ovid Medline ( External Link ). The other searches have been adapted from this one to accommodate the search engine of each specific database.

  1. exp Aged/
  2. (older adj2 (adult$ or person$ or people$ or man or men or wom$n)).ti,ab.
  3. elderly.ti,ab.
  4. (senior citizen$ or seniors).ti,ab.
  5. exp Exercise Movement Techniques/
  6. Sports/
  7. Dancing/
  8. gardening/
  9. (yoga$ or tai chi or aerobics or weight lifting or weight training or strength training).ti,ab.
  10. (physical activity or exertion or physical fitness).ti,ab.
  11. pc.fs.
  12. (intervention$ or prevent$ or treatment$ or program$).ti,ab.
  13. therap$.ti.
  14. homes for the aged/ or exp nursing homes/
  15. (homebased or home-based or communit$ or center or centre or gym$).ti,ab.
  16. supervised.ti,ab.
  17. or/1-4
  18. or/5-10
  19. or/11-13
  20. or/14-16
  21. 17 and 18 and 19 and 20

Filter

The following filter was used to include only randomised controlled trials or systematic reviews:

  1. ("review" or "review academic" or "review tutorial").pt.
  2. (medline or medlars or embase).tw,sh
  3. (scisearch or psychinfo or psycinfo).tw,sh.
  4. (psychlit or psyclit).tw,sh.
  5. cinahl.tw,sh.
  6. ((hand adj2 search$) or (manual$ adj2 search$)).tw,sh.
  7. (electronic database$ or bibliographic database$ or computeri?ed database$ or online database$).tw,sh
  8. (pooling or pooled or mantel haenszel).tw,sh.
  9. (peto or dersimonian or der simonian or fixed effect).tw,sh.
  10. or/2-9 47239
  11. 1 and 10
  12. meta-analysis.pt.
  13. meta-analysis.sh.
  14. (meta-analys$ or meta analys$ or metaanalys$).tw,sh.
  15. (systematic$ adj5 review$).tw,sh.
  16. (systematic$ adj5 overview$).tw,sh.
  17. (quantitativ$ adj5 review$).tw,sh.
  18. (quantitativ$ adj5 overview$).tw,sh.
  19. (quantitativ$ adj5 synthesis$).tw,sh
  20. (methodologic$ adj5 review$).tw,sh.
  21. (methodologic$ adj5 overview$).tw,sh.
  22. (integrative research review$ or research integration).tw.
  23. or/12-22
  24. 11 or 23
  25. exp Randomized controlled trials/
  26. "randomized controlled trial".pt.
  27. "controlled clinical trial".pt.
  28. (random$ or placebo$).ti,ab,sh.
  29. ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$)).tw,sh.
  30. or/25-29
  31. (animals not humans).sh.
  32. 30 not 31